Reproductive medicine spans the reproductive years and therefore includes the management of adolescents as well as women approaching the menopause. We focus on patients between these extremes and particularly couples with subfertility and those who have experienced complications in early pregnancy.
We approach these issues in a variety of ways but a significant part of our work involves imaging and specifically ultrasound. We use a variety of ultrasound techniques (2D, 3D, Doppler, and contrast) which we combine with biomarkers to assess disease processes both qualitatively and quantitatively. We also use these techniques to explore physiology and address ‘uncertainties’ in reproductive medicine.
What we are doing about...
We are conducting a range of studies to better understand the causes of subfertiltiy and to provide individualised treatment protocols based on a woman’s ovarian reserve and endometrial receptivity.
2. Problems in Early Pregnancy
We are conducting a study to explore the uncertainties in early pregnancy including pregnancies of unknown location and uncertain viability.
To do this we are revisiting the historical data that exist on the development of normal early pregnancies and then applying this to complicated pregnancies.
We are also exploring the effect of subfertility, assisted conception and multiple pregnancy on early development and longterm outcome.
Finally we are conducting studies looking at the effect of pelvic pathology and its’ treatment on both conception and pregnancy outcome. A key area in this respect is the role of congenital uterine anomalies and hysteroscopic resection of uterine septae.
Ovarian hyperstimulation (OHSS)
We are just starting two randomised controlled trials looking at the prevention and early treatment of OHSS.
One study is looking at the role of the GnRH agonist trigger in women considered to be at high risk of OHSS before treatment is started whilst the other will focus on women developing risk factors during treatment and the role of dopamine agonists.
Part of this work involves pharmocogenotyping of women especially those demonstrating resistance to clomiphene citrate which we are doing in collaboration with The Institute of Translational Medicine in Liverpool (Ana Alfirevic).
Endometrial receptivity and implantation failure
We have a series of studies looking at the role of the endometrium in the implanation process.
The Endoscratch Study is a randomised controlled trial looking at the effect of endometrial biopsy in women undergoing assisted conception treatment.
We are also investigating the role of natural killer (NK) cells and other markers of decidualisation with the Reproductive Health team at the University of Warwick (Professors Jan Brosens and Siobhan Quenby).
Uncertainties in early pregnancy
Miscarriage and ectopic pregnancy are increasingly common and largely unpreventable.
Despite this there are many uncertainties in early pregnancy both in respect of when things go wrong and in the normal developmental processes.
We are conducting a series of studies to see where treatment strategies could be targetted. Some of these uncertainties are being highlighted in a series of systematic reviews we are conducting in conjunction with the School of Clinical and Experimental Medicine in Birmingham (Professor Arri Coomarasamy).
Publications in leading peer-reviewed journals. Please see the publication records under our members' profiles.
NURTURE provides a high quality clinical service in assisted reproduction techniques and a teaching and research base in this area.